Department of Pediatrics, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan.
Eur J Pediatr. 2010 Jul;169(7):861-6. doi: 10.1007/s00431-009-1132-8. Epub 2010 Jan 6.
Pneumococcal/lobar pneumonia and empyema have an important impact on the health of children worldwide. There has been no epidemiological study of pneumococcal/lobar pneumonia and empyema in Taiwan, a middle-income Asian population. Using Taiwan's National Health Insurance database, we collected and analyzed data obtain from medical care claims related to pneumococcal/lobar pneumonia and empyema for children below the 18 years old from 1997 to 2004. We found the annual population-based incidence to have significant year to year increases and the average annual incidences of pneumococcal/lobar pneumonia and empyema in children under five to be 44.9 and 10.5 episodes per 100,000 children-year, respectively. About 64% of children with pneumococcal/lobar pneumonia and empyema were under 5 years old. Children 4 to 5 years old had the highest incidences of both pneumococcal/lobar pneumonia and empyema. Incidence was the highest each spring. The odds ratio of the case fatality among pneumococcal/lobar pneumonia patients complicated with empyema to those without was 118 (95% confidence interval 28-492). In conclusion, the population-based incidences of pneumococcal/lobar pneumonia and empyema among children under five in Taiwan were 44.9 and 10.5 episodes per 100,000 children-year, respectively, and 4- to 5-year-old children had the highest incidences of both pneumococcal/lobar pneumonia and empyema. This population might benefit from a universal pneumococcal vaccination program which might cover about 70% of invasive pneumococcal diseases in Taiwanese children under 5 years old.
肺炎球菌性/大叶性肺炎和脓胸对全球儿童的健康有重要影响。在中低收入的亚洲人群中，尚未对台湾的肺炎球菌性/大叶性肺炎和脓胸进行过流行病学研究。本研究利用台湾全民健康保险数据库，收集并分析了 1997 年至 2004 年期间与 18 岁以下儿童肺炎球菌性/大叶性肺炎和脓胸相关的医疗费用理赔数据。结果发现，肺炎球菌性/大叶性肺炎和脓胸的年发病率呈显著逐年上升趋势，5 岁以下儿童的平均年发病率分别为 44.9 和 10.5 例/10 万人年。约 64%的肺炎球菌性/大叶性肺炎和脓胸患儿年龄在 5 岁以下，4-5 岁儿童的肺炎球菌性/大叶性肺炎和脓胸发病率最高，且发病率在每年春季最高。伴有脓胸的肺炎球菌性/大叶性肺炎患者的病死率是非脓胸患者的 118 倍（95%可信区间 28-492）。总之，台湾 5 岁以下儿童肺炎球菌性/大叶性肺炎和脓胸的发病率分别为 44.9 和 10.5 例/10 万人年，4-5 岁儿童的发病率最高。此类人群可能受益于普遍的肺炎球菌疫苗接种计划，该计划可能覆盖台湾 5 岁以下儿童侵袭性肺炎球菌病的 70%左右。
